Flawed reasoning

A letter to the editor published in today's edition of The Chronicle Herald:

There is a flaw in John Roswell’s reasoning when he writes (Jan. 17), “I believe that most people who have experienced psychosis would agree with me that people should be held responsible for their criminal acts, no matter what their state of mind was when they committed the crime.”

It is the accused who ultimately determines whether or not to proceed with a defence of not criminally responsible on account of mental disorder. Therefore, if the accused, once found fit to stand trial, believes that psychosis, for example, is the reason they should be found not criminally responsible, they will instruct their defence counsel to present this argument in court.

With regard to better access to mental health services, many people experiencing psychosis have lost contact with reality to such an extent that they do not believe they are ill. Therefore, they do not seek treatment for their mental disorder, despite the efforts of family and friends to assist them. This is one reason why the Nova Scotia legislature passed the Involuntary Psychiatric Treatment Act in December 2005.

Stephen W. Ayer, Executive Director, Schizophrenia Society of Nova Scotia

IWK cuts waiting list by deleting names

An article published in today's edition of The Chronicle Herald:

1,100 child mental health patients affected

By Selena Ross

What does it take to get off a waiting list?

Of the 1,100 children removed since November from the IWK Health Centre’s waiting list for mental health services — an astonishing statistic the Halifax children’s hospital released widely on Monday — about half weren’t treated, and the hospital removed many of those without directly contacting them.

That’s because the IWK sent a letter to all families on the waiting list in September or October asking them to call back if they still wanted service.

Many didn’t call back. The list was instantly cut back by about half, the vice-president of patient care, Jocelyn Vine [pictured], said Thursday.

Since then, the hospital has screened hundreds of children for the first time, leaving 70 on the waiting list. But on Tuesday, Vine described that overall 94 per cent reduction as a "really very profound improvement in access to care" without explaining that hundreds of names had simply been deleted.

The hospital used the numbers this week to show its success under a reorganization that included the layoff of 22 youth-care workers.

Parents and mental health advocates challenged the math after reading about the hospital’s announcement this week.

"I had a feeling . . . I just wondered what had happened to that 1,030 people," said John Roswell of the Digby Clare Mental Health Volunteers Association.

"If they could see 1,100 people in three months, we could clean up the mental health waiting lists throughout the province in a big hurry."

Roswell said he called Vine on Wednesday to ask how the hospital came up with the numbers, and she explained the mass mail-out.

"I couldn’t believe what she said," he said. "I just thought it was a terrible misrepresentation of the facts.

"I understand their point about improving patient care and decreasing wait times. I mean, that’s all very applaudable, but I think we need to be upfront about it."

The mother of a 10-year-old Dartmouth boy who waited 14 months for a first appointment said she responded to several surveys the hospital mailed out during that time to reaffirm that the family still wanted care.

Last fall, the letter contained a deadline, said Carol Mack, whose son suffers from anxiety-related problems.

"It was something about how they were reorganizing their wait times . . . then you had to call this phone number, which is the Dartmouth clinic, I believe. (It said) if you are still requiring services, you have to call it by this certain date. Otherwise you’ll be removed from the wait list."

As Mack remembers it, she had about a month to call.

"But if they didn’t have the current phone number or address for someone, you were out of luck. Or, say, someone just missed it, you’d be totally kicked off the list."

Vine said Thursday that the hospital made extra efforts to get in touch with families who didn’t respond. Some also phoned to say they no longer needed care, she said.

Those who didn’t speak to the hospital were taken off the list, but they’re free to call and re-add their names any time they want, she said.

"Some chose to call in. Some didn’t," she said. "It’s totally up to them."

The numbers on the waiting list are not misleading, Vine said. Services were offered to all 1,100 families.

"We can only go by the data that we have. It’s a completely accurate number, based on the information that we had. We went back and re-engaged with people. . . . Based on their answer, we’re moving forward accordingly."

The hospital’s overall progress in the mental health unit is not in doubt, Vine said. Since November, the unit has sped up the rate at which it handles new patients and is seeing more children per week than previously.

She said she had no statistics showing that change.

Image credit

Also see:

Wait times too long for some (March 18th)

Mental health care more than hocus-pocus (March 17th)

IWK changes emphasize early intervention (March 15th)

Decision to dispense with 22 youth workers is disgraceful (March 15th)

22 layoffs in IWK mental health program (March 12th)

Mental health treatment for NS teenagers is in crisis! (June 10th, 2010)

Yarmouth area attracts MDs

An article published in the January 3rd edition of The Chronicle Herald:

By Brian Medel, Yarmouth Bureau

YARMOUTH — Several physicians, including a number of psychiatrists, began practising in southwestern Nova Scotia during the summer and fall of 2011.

Three psychiatrists joined Southwest Health recently, bringing the number of psychiatrists to six in Nova Scotia’s westernmost health district.

All psychiatrist vacancies for the district are filled for the first time in more than 10 years, Southwest Health said in a news release.

Dr. Olufemi Banjo came in August, followed by Dr. Razi Hemani in September and Dr. Lourdes Soto-Moreno (pictured) in October.

"It certainly is good news, and hopefully we’ll hold on to them; there’s certainly the need," said John Roswell, a Digby Clare Mental Health Volunteers co-ordinator, on Sunday.

"It’s terrific if we have the full complement. Hopefully, it will mean that people get to see a psychiatrist and eliminate the lengthy wait process.

"It has been practically impossible to get to see a psychiatrist within six months, and it’s very heartening to hope that wait times may be decreased somewhat because of this."

The common wisdom is that 20 per cent of people will require psychiatric services or will experience a mental illness at some point during their lifetime, said Roswell.

The reporting of mental illness and the number of people seeking help has increased, he said.

Dr. Faten Germanus began working at a family medical practice in Barrington Passage in December. She is not yet accepting patients but an announcement will be made soon when she is ready to take on new patients, according to a news release.

Dr. Navdeep Mangat also began working in Digby General Hospital’s emergency department in December and will provide services at the Digby Well Womens Clinic starting this month.

And southwestern Nova Scotia residents with no family doctor but who have high blood pressure may take advantage of a new cardiovascular program at Yarmouth Regional Hospital, to be based in the facility’s wellness centre.

(bmedel@herald.ca)

Photo credit

Mental-health program for Digby schools gains national attention

An article published in today's edition of The Chronicle Herald:

By Brian Medel, Yarmouth Bureau

Digby County proponents of an adolescent mental-health curriculum being included in area high schools have received national attention.

The Mental Health Commission of Canada has asked if they can use a local program in a new national anti-stigma campaign.

"We’re very excited about being part of this campaign," John Roswell, the co-ordinator of the Digby Clare Mental Health Volunteers, said Tuesday.

"Our mandate is to promote the mental health of Digby County residents and we are trying to overcome the prejudice and discrimination faced by people with mental illness in our community.

"We have been focusing on adolescent mental health in particular and this is one of the areas the commission is concentrating on."

Mr. Roswell said his group has been working for several months to introduce information about mental health and illness into the curriculum of Digby County high schools. It now looks like the program will begin during the 2010-2011 school year.

"The (Canadian) Mental Health Commission will be helping us measure the effectiveness of our program," said Mr. Roswell.

The Digby County group has also joined forces with the Sun Life Financial Chair of Adolescent Mental Health at Dalhousie University and the IWK Health Centre to help with their project.

Dr. Stan Kutcher, an adolescent mental health expert at Dalhousie University’s school of medicine, spoke to Digby County teachers Tuesday, providing information on mental health and disease.

Mr. Roswell said 80 per cent of all psychiatric disorders emerge in adolescence and it would be good for people to have some understanding of them.

"Mental illnesses affect more people, directly or indirectly, than any physical illness," he said, adding that 83 per cent of Digby County high school students surveyed by his association recently said they knew someone with a mental illness.

And yet mental illness is something people don’t like to talk about, said Mr. Roswell.

"We’re trying to overcome that by creating a dialogue in our community. We’re trying to help people see that it’s OK to admit that you might have a mental illness."

Teens to learn about mental health

An article published in today's edition of The Chronicle Herald:

Pilot project could be coming to Digby County high schools in new year

By Brian Medel, Yarmouth Bureau

High school curriculum designed to teach students about mental illness may be coming to Digby County classrooms in January as a pilot project.

"This is new," said John Roswell, one of the program co-ordinators with the Digby-Clare Mental Health Volunteers Association.

"We hope to do it during the 2009-2010 school year, hopefully beginning in January," Mr. Roswell said about the project that will be conducted in four local high schools.

He hopes the curriculum will someday be included in all Nova Scotia high schools.

The curriculum was prepared by Dr. Stan Kutcher [pictured] in co-operation with the Canadian Mental Health Association.

"This is really a wonderful opportunity," said Dr. Kutcher, an adolescent mental health expert at Dalhousie University’s school of medicine.

The course will give students information on how the brain works and tell them how to maintain good mental health. Suicide prevention and depression will also be discussed, Dr. Kutcher said Tuesday.

He’ll help teachers better understand mental illness and the new curriculum in special workshops that will be held before the start of the course.

"They’ve been very enthusiastic about this," said Dr. Kutcher.

Next week, staff from the Education and Health departments, along with representatives from local school boards and health authority, will gather in Digby to talk about the new high school course and how it will be implemented.

"We’re not quite sure where it will fit . . . that’s part of what this discussion is going to be about," said Mr. Roswell. "We hope to make (it) a larger project . . . an overall approach to addressing adolescent mental health.

"We’re trying to create a dialogue around this issue in the community and make it OK for people to talk about mental health and mental illness."

Mr. Roswell said 80 per cent of all psychiatric disorders emerge in adolescence. He had mental illness as a young person but was undiagnosed until the age of 40.

"My life would have been so much different had I been diagnosed as a teenager," he said.